Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. The goal of evolutionary medicine is to understand why people get sick, not simply how they get sick. Modern medical research and practice has focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. (1)
The main focus of this blog
Darwinian medicine encompasses a broad range of evolutionary theories, concepts, and principles. On this blog, the main focus is on evolutionary mismatches.
The premise of this site is that many diseases and health disorders are caused by a mismatch between the human genome and the modern environment (including the human microbiome, which can be considered to be a part of the environment) (2, 3, 4).
Paleolithic, natural environments are considered to be the Environments of Evolutionary Adaptedness (EEA) for humans (5, 6). Studies consistently show that hunter-gatherers (both ancient and modern-day) and traditional people who live in an environment that resembles humans’ EEA are lean, fit, and largely free of chronic degenerative diseases (2, 3, 5). This phenotypic expression can be classified as the evolutionary norm for Homo sapiens sapiens.
This doesn’t mean that we stopped evolving with the Neolithic Revolution or that we should abandon all modern foods, lifestyle habits, and medical innovations. It simply means that we should always keep in mind that we are still – to a significant extent – adapted to live as hunter-gatherers in the wild.
The purpose of this site is to find ways to align our modern diet, lifestyle, and living conditions with our ancient genetic identity, without having to move into the wild and give up all of the comforts we enjoy about modern life.
The etiology, prevention, and treatment of the diseases of civilization: A Darwinian conceptual framework
The science of Darwinian medicine
The field of Darwinian medicine is built upon a solid foundation of scientific evidence. Below is a selection of papers and studies that explain what this non-conventional medical approach is all about.
- Medicine in the 21st century: towards a Darwinian medical epistemology.
- The great opportunity: Evolutionary applications to medicine and public health
- Evolutionary medicine: its scope, interest and potential
- How is Darwinian medicine useful?
- The dawn of Darwinian medicine.
- 99th Dahlem conference on infection, inflammation and chronic inflammatory disorders: darwinian medicine and the ‘hygiene’ or ‘old friends’ hypothesis.
- Does Medicine without Evolution Make Sense?
- Evolution, health and disease – Darwinian approaches to medicine.
- Darwinian medicine – an evolutionary perspective on health and disease
- Evolutionary science as a method to facilitate higher level thinking and reasoning in medical training
- A Clinical Perspective in Evolutionary Medicine: What We Wish We Had Learned in Medical School
This quote from article number one in the list above nicely summarizes how evolutionary theory can help illuminate our understanding of health and disease:
Prudence dictates that it is high time medicine broadened its scope beyond an evidence-based epistemology. The evidence-based methodologies are focused primarily on immediate problem-solving and proximate causation. Medicine must embrace the evolutionary paradigm that welcomes ultimate explanations as espoused in evolution into its epistemology. Through this door will enter into medicine the concepts of systems biology, dynamical systems theory, complex systems, complex networks, and chaos theory, to name some up-and-coming analytical methodologies that should pry medicine out of its linear thinking (79). Because H.s. sapiens is the product of an evolutionary process, we cannot hope to have a deep understanding of the major diseases of our age if we ignore our evolutionary past. In the depths of our minds as in our genes, we are all African hunter-gatherers.
Besides helping us understand why we get sick, Darwinian medicine is also of great practical use. Millions of people worldwide swear by a Paleo-inspired lifestyle, the ancestral health movement has gained massive traction these last couple of years, and evolutionary health principles are increasingly being incorporated into clinical medical practise.
The Paleo Physicians Network, a network that aims to provide a simple interface between health conscious consumers and the medical professionals who practice Darwinian/Evolutionary Medicine, has the following to say about the practical applications of Darwinian medicine:
Despite the advances of modern medicine the pharmo-centric approach has failed to address the complex degenerative diseases plaguing Western societies. “Magic Bullets” for cardiovascular disease, neurodegeneration, cancer and infertility are oddly lacking given our remarkable understanding of the pathogenesis of these and other diseases. Unlike infectious disease, Western degenerative diseases do not lend themselves to simple pharmaceutical solutions. The limitations of modern medicine lie not in a lack of technology or understanding of disease process, but in an epistemological framework consistent with complex biological systems. To be effective, modern medicine must adopt the same framework the rest of the biological sciences have benefited from for over 100 years: Evolution via Natural Selection.
For non-emergent (life threatening) situations the first intervention for most issues should derive from an Evolutionarily consistent framework including, Paleo Nutrition, sleep patterns, socialization, and exercise which is consistent with the processes which formed the H. Sapien genome. (6)
The following 7 lifestyle factors have a particularly potent impact on human health and are therefore given the most attention on this blog: